It is now known that ethnic minorities are less likely to receive quality health services and evidence worse treatment outcomes when compared with other groups (IOM, 1999;USDHHS, 2001). Moreover, there continues to be a shortage of systematic investigations examining the efficacy of evidence-based treatments (EBTs) with ethnic minorities, especially among Chinese Americans. Developing interventions that are both empirically grounded and that are culturally sensitive and compatible with Chinese culture is one promising strategy that may improve treatment outcomes for this understudied group. The goal of this study is to culturally adapt a cognitive-behavioral therapy manual for use with depressed Chinese American patients. This study will be among the first to develop a culturally adapted EBT for use with this ethnic group and will involve three study phases. Phase I of the study will focus on modifying and refining a CBT intervention protocol into a manualized treatment for Chinese Americans. Phase two involves a randomized controlled trial (RCT) comparing the effects of the culturally adapted CBT treatment manual with nonadapted CBT. Phase three will involve further refinement of the treatment manual, data analysis, and report writing. Seventy-six patients will be recruited from an ethnic-specific mental health center that specializes in treating Asian American clientele to participate in the study. The adapted manual will be pilot tested on 4 patients and further refinements will be made before entering the RCT phase. Seventy-two patients (36 in each condition) will be randomly assigned to either the adapted CBT treatment or the nonadapted CBT treatment. Moreover, feedback from patients and therapists in both conditions will be used to further refine the new treatment manual, provide valuable information about salient issues in treating depressed Chinese Americans, and will provide initial estimates of treatment parameters that will be used in preparing a larger R01 application to further test the adapted intervention. This project will help us understand whether cultural adaptations to cognitive-behavioral therapy will improve treatment outcomes for Chinese Americans. This research is significantly relevant to public health because it has implications for how to improve mental health services for ethnic minorities, an area severely under researched.